Australian National Council on Drugs takes a deep breath on cannabis

Julia Medew and Dan Harrison

Pharmaceutical cannabis is effective for treating some forms of pain, reducing nausea and helping people gain weight, but there are barriers to medical use in Australia, the federal government's principal drug advisory group says.

An Australian National Council on Drugs' report on medicinal cannabis published on Monday said research suggested a number of cannabis pharmaceuticals could treat pain, particularly chronic and neuropathic pain, the latter of which is caused by injuries to the nervous system.

The background and information paper said clinical trials of various cannabinoids had also shown they could treat spasticity associated with multiple sclerosis and stimulate appetite and weight gain in people with HIV, advanced cancer and anorexia.

While cannabinoids may be able to treat epilepsy, glaucoma, obsessive-compulsive disorder, schizophrenia, Tourette's syndrome and spinal cord injuries, the report said the evidence for its use in these conditions was less clear.

The analysis, which aimed to identify areas that require "further action or investigation", comes amid growing calls for medicinal cannabis to be legalised in Australia. On Sunday, Victorian Opposition Leader Daniel Andrews said that if he was elected in November, he would ask the Victorian Law Reform Commission to report on how the prescription manufacture and distribution of medical cannabis could be legalised.

The ANCD report said while three medical cannabis products had been developed, only one of them - Sativex - had been approved for use by the Therapeutic Goods Administration in Australia to treat multiple sclerosis. Some Australian cancer patients are also part of a global trial of Sativex to see if it relieves difficult-to-treat cancer pain. The trial is expected to continue for another year.

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The ANCD report said that while pharmaceutical companies could continue to apply for cannabis products to be used for particular conditions, approval takes a "significant length of time" and Australia's small market for such products may not offer sufficient incentive to manufacturers. Furthermore, it said Sativex cost about $500 per month in 2013, suggesting that some people would opt for cheaper "crude cannabis" unless it was listed on the Pharmaceutical Benefits Scheme.

It said while arguments for enabling crude cannabis (herbal cannabis) could thus be made on the basis of easier manufacture and lower costs, this raised legal and regulatory complexities. Few clinical trials had also tested it and there were concerns about the health risks associated with its administration, especially if smoked, for example.

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On Monday, Damian Zammit, of Croydon Hills in Melbourne, welcomed more debate about medicinal cannabis. Mr Zammit's 10-year-old daughter, Imogen, has Dravet syndrome, and the family have tried more than a dozen medications to treat her severe seizures, largely without success.

Since seeing other families successfully use cannabis oil to treat seizures in children with Dravet syndrome, the Zammits have wanted to see if it could help Imogen.

But they have no access to the drug, and even if they were able to source it, have fears that obtaining it illegally could endanger the job of Imogen's mother Nancy, a schoolteacher.

Mr Zammit said on Monday that he was pleased that the medicinal potential of cannabis was receiving attention, and would be interested in the Victorian Liberal Party's position and the outcome of Victorian Labor's push toward decriminalisation. "I'm a bit sceptical until it actually happens," Mr Zammit said.

Greens senator Richard Di Natale said he welcomed action by state MPs, but a federal response was needed.

"No matter what Victoria does, cannabis will remain illegal," he said. "People will need to meet dealers to source their medicine. They shouldn't have to do that."

Senator Di Natale said he was preparing legislation to change the scheduling of cannabis so that it was no longer classified as an illicit drug, and to provide a framework for licensing growers and dispensaries.

A spokeswoman for the Commonwealth government said: "Decriminalisation of personal use of cannabis where there are clear compassionate circumstances is an option which state and territory governments can pursue under their respective drugs and poisons control legislation should they choose to do so."